A Comparison of the Quality of Maternity Care between a Health-Maintenance Organization and Fee-for-Service Practices

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Abstract
An intense controversy surrounds the promotion of the health-maintenance organization (HMO) as an alternative to the traditional fee-for-service (FFS) system of medical care. Advocates of HMOs believe that this system can produce considerable savings without sacrificing the quality of care.1 , 2 Opponents have charged that HMOs keep costs down by "skimming" their enrollment from the younger and healthier segments of the population and by "skimping" on the provision of services even when they are medically indicated.3 An issue still under discussion is whether HMOs deliver health care of a quality comparable to that of the FFS sector.4 Using multiple indicators of . . .

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